Provider Demographics
NPI:1376846006
Name:KIM, DANIEL D (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:KIM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14935 NE 87TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2046
Mailing Address - Country:US
Mailing Address - Phone:258-883-3525
Mailing Address - Fax:425-883-1076
Practice Address - Street 1:32129 WEYERHAEUSER WAY S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98001-9801
Practice Address - Country:US
Practice Address - Phone:360-933-4892
Practice Address - Fax:360-933-1197
Is Sole Proprietor?:No
Enumeration Date:2010-12-20
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60163670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist